Department of Health Disparities Research, The University of Texas M. D. Anderson Cancer Center, PO Box 301402-Unit 639, Houston, TX 77230-1402, USA.
Cancer. 2011 Jan 15;117(2):390-7. doi: 10.1002/cncr.25397.
Overall, Latinas are more likely to be diagnosed with a more advanced stage of breast cancer and are 20% more likely to die of breast cancer than non-Hispanic white women. It is estimated that from 2003 to 2006, $82.0 billion in direct medical care expenditures, in addition to 100,000 lives annually, could be saved by eliminating health disparities experienced by Latinos and increasing the use of up to 5 preventive services in the United States. An additional 3700 lives could be saved if 90% of women aged ≥40 years were recently screened for breast cancer.
The authors examined the risk for breast cancer in a case-control, population-based sample of Mexican-origin women in Harris County, Texas (n=714), where the rates of breast cancer mortality for Latina women have doubled since 1990.
Half of breast cancer cases (n=119) were diagnosed in women aged <50 years. In a multivariate model, women who had a family history of breast cancer (odds ratio [OR], 4.3), who were born in Mexico and had high levels of language acculturation (OR, 2.5), and who did not have health insurance (OR, 1.6) had the highest risk for breast cancer.
Because the current results indicated that Mexican-origin women are at high-risk for early onset, premenopausal breast cancer, the authors recommended policies that target screening, education, and treatment to prevent increased disparities in mortality. The authors concluded that the inclusion of community members and policymakers as partners in these endeavors would further safeguard against an increase in cancer health disparities and aid in formulating a policy agenda congruent with scientifically based, community-driven policy efforts that address breast cancer screening, education, and treatment in this vulnerable population.
总体而言，拉丁裔女性被诊断出患有更晚期乳腺癌的可能性更高，死于乳腺癌的风险比非西班牙裔白人女性高 20%。据估计，从 2003 年到 2006 年，通过消除拉丁裔人群所面临的健康差距并增加美国 5 项预防性服务的使用，可节省 820 亿美元的直接医疗保健支出，并避免每年 10 万人死亡。如果 90%的 40 岁及以上的女性最近都接受了乳腺癌筛查，还可以额外挽救 3700 条生命。
作者在德克萨斯州哈里斯县（Harris County）对墨西哥裔女性进行了一项基于人群的病例对照研究，该研究考察了乳腺癌的发病风险（n=714）。自 1990 年以来，该地区拉丁裔女性的乳腺癌死亡率增加了一倍。
一半的乳腺癌病例（n=119）发生在 50 岁以下的女性中。在多变量模型中，有乳腺癌家族史（比值比[OR]，4.3）、出生于墨西哥且具有较高语言融入度（OR，2.5）以及没有医疗保险（OR，1.6）的女性乳腺癌发病风险最高。
由于目前的结果表明，墨西哥裔女性有较高的早发性、绝经前乳腺癌风险，作者建议采取针对筛查、教育和治疗的政策，以防止死亡率的差异进一步扩大。作者总结说，将社区成员和决策者纳入这些努力的合作伙伴中，将进一步防止癌症健康差距的扩大，并有助于制定与科学为基础、社区驱动的政策努力相一致的政策议程，这些政策努力解决了这一脆弱人群的乳腺癌筛查、教育和治疗问题。
